title: The San Francisco Syncope Rule performs well in a regional rural emergency department in New Zealand.
abstract: OBJECTIVE
  To assess the utility of a decision rule for determining short-term risk in syncope patients presenting to the Emergency Department (ED) of Nelson Hospital (Nelson, New Zealand).
  
  
  METHODS
  Sixty-eight of 83 eligible syncope patients who presented to the ED with syncope were consecutively enrolled. Follow-up for an adverse event within 7 days of index presentation was performed. Actual event rate was compared with the prediction tool known as the San Francisco Syncope Rule (SFSR).
  
  
  RESULTS
  Sensitivity and specificity for the SFSR was 83% (95% Confidence Interval (CI) of 44-97%) and 82% (95%CI 71-91%) respectively. There was a negative predictive value of 98% (95% CI 90-99%). Positive and negative likelihood ratios were 4.7 (95% CI 2.5-9.0) and 0.2 (95% CI 0.03-01.22) respectively.
  
  
  CONCLUSIONS
  Syncope patients who present to the ED with no obvious cause and who are being considered for discharge may benefit from application of the SFSR for short-term risk assessment.
authors.affiliation: Emergency Department (FACEM), Nelson Hospital, Nelson, New Zealand. andrew.munro@nmdhb.govt.nz
authors.forename: Andrew
authors.initials: A
authors.lastname: Munro
authors.forename: Rosie
authors.initials: R
authors.lastname: Whittaker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology; D001794:Blood Pressure; D002423:Cause of Death; D016001:Confidence Intervals; D003661:Decision Support Techniques; D004417:Dyspnea / Q000150:complications; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D006333:Heart Failure / Q000150:complications; D006400:Hematocrit; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009520:New Zealand; D010138:Pacemaker, Artificial; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000209:etiology; D018570:Risk Assessment / Q000379:methods*; D019035:Rural Health Services; D020521:Stroke / Q000209:etiology; D013575:Syncope / Q000150:complications*; D055815:Young Adult